Alcohol and Head and Neck Cancer: Updates on the Role of Oxidative Stress, Genetic, Epigenetics, Oral Microbiota, Antioxidants, and Alkylating Agents

Head and neck cancer (HNC) concerns more than 890,000 patients worldwide annually and is associated with the advanced stage at presentation and heavy outcomes. Alcohol drinking, together with tobacco smoking, and human papillomavirus infection are the main recognized risk factors. The tumorigenesis of HNC represents an intricate sequential process that implicates a gradual acquisition of genetic and epigenetics alterations targeting crucial pathways regulating cell growth, motility, and stromal interactions. Tumor microenvironment and growth factors also play a major role in HNC. Alcohol toxicity is caused both directly by ethanol and indirectly by its metabolic products, with the involvement of the oral microbiota and oxidative stress; alcohol might enhance the exposure of epithelial cells to carcinogens, causing epigenetic modifications, DNA damage, and inaccurate DNA repair with the formation of DNA adducts. Long-term markers of alcohol consumption, especially those detected in the hair, may provide crucial information on the real alcohol drinking of HNC patients. Strategies for prevention could include food supplements as polyphenols, and alkylating drugs as therapy that play a key role in HNC management. Indeed, polyphenols throughout their antioxidant and anti-inflammatory actions may counteract or limit the toxic effect of alcohol whereas alkylating agents inhibiting cancer cells’ growth could reduce the carcinogenic damage induced by alcohol. Despite the established association between alcohol and HNC, a concerning pattern of alcohol consumption in survivors of HNC has been shown. It is of primary importance to increase the awareness of cancer risks associated with alcohol consumption, both in oncologic patients and the general population, to provide advice for reducing HNC prevalence and complications.

Frequency and Risk Indicators of Periodontal Diseases in a Sample of Adult Egyptian Patients: A Hospital-Based Cross-Sectional Study

This hospital-based cross-sectional study aimed at determining frequency and risk indicators/predictors of periodontitis in a sample of Egyptian adult population and to develop a prediction equation for classifying periodontal diseases. Seven hundred and fifty subjects were consecutively recruited from outpatient Diagnostic Center, Faculty of Dentistry, Cairo University. Validated oral health questionnaire for adults and oral health impact profile-14 (OHIP-14) questionnaire were filled by all patients. Diagnosis was made based on measurements of clinical periodontal parameters including plaque index, bleeding on probing, pocket depth, clinical attachment level and gingival recession. Radiographic examination was performed using digital periapical radiographs. Ordinal logistic regression analysis was used to determine significant predictors of periodontal diseases and discriminant analysis was performed to predict periodontal disease classification. Gingivitis was the most frequent periodontal disease (39.6%) followed by periodontitis stage I (38%), stage II (20.4%), stage III (1.6%) and stage IV (0.4%). The lowest OHIP-14 scores were in patients with periodontitis stages III and IV. Multivariate analysis showed that education (p < 0.001), OHIP-14 score (p = 0.003), non-smoking (p = 0.001) and non-alcohol drinking (p = 0.021) were significant negative predictors, while never to clean the teeth (p < 0.001) were significant positive predictors of periodontal disease. Periodontitis stages III and IV were the least frequent on a sample of Egyptian adult patients. Education, frequency of teeth cleaning, smoking, alcohol drinking and OHIP-14 scores were significant predictors of periodontal disease. Through discriminant analysis this study could classify patients into different periodontal diseases with an overall correct prediction of 99.2%.

Dynamics of anti-Spike IgG antibody level after full BNT162b2 COVID-19 vaccination in health care workers

Introduction: The administration of a third vaccine is ongoing in many countries, but the evaluation of vaccine-induced immunity is still insufficient. This study evaluated anti-spike IgG levels in 373 health care workers six months after the BNT162b2 vaccination. Methods: Dynamics of anti-spike IgG levels six months after the 2nd vaccination were assessed in 49 participants (Analysis-1). A cross-sectional assessment of anti-spike IgG level was performed in 373 participants (Analysis-2). Participants positive for anti-nucleocapsid IgG or IgM and receiving immunosuppressants were excluded from Analysis-2. Results: In Analysis 1, the median anti-spike IgG level was lower in the older age group and decreased consistently after the second vaccination regardless of age. In Analysis-2, the anti-spike IgG level was significantly negatively associated with age (r = -0.35, p < 0.01). This correlation remained statistically significant (r = -0.28, p < 0.01) even after adjusting for sex, BMI, smoking habits, alcohol drinking habits, allergies, and the presence of fever or other adverse reactions at the time of the vaccination. Alcohol drinking habit was also associated with the anti-spike IgG level; daily alcohol drinkers had significantly lower anti-spike IgG levels than never alcohol drinkers. Sex, smoking habit, allergy, and fever and other side effects after the vaccination were not associated with anti-spike IgG levels six months after the 2nd vaccination. Conclusions: Six months after the vaccination, the anti-spike IgG level was substantially low among older persons and daily alcohol drinkers.